Provider Demographics
NPI:1083071799
Name:STEPHEN S CARRYL, MD PC
Entity Type:Organization
Organization Name:STEPHEN S CARRYL, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN OF SURGERY
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:CARRYL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-963-6485
Mailing Address - Street 1:93-95 WYCKOFF AVENUE
Mailing Address - Street 2:STEPHEN S CARRYL, MD PC
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11237
Mailing Address - Country:US
Mailing Address - Phone:718-963-5535
Mailing Address - Fax:
Practice Address - Street 1:93-95 WYCKOFF AVENUE
Practice Address - Street 2:STEPHEN S CARRYL, MD PC
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237
Practice Address - Country:US
Practice Address - Phone:718-963-5535
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STEPHEN S CARRYL, MD PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-01-26
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center